Helping Oncology Nurses Cope When Nothing More Can Be Done for the Patient

Handling difficult patient care situations and dealing with patient death can take a toll.

I watched Yvonne slump over the computer. Her fingers slowly clicked the keyboard as she entered data. At nearly 6:00 pm, her poor posture possibly only signaled that she was tired at the end of a long shift. But I knew she was taking care of a sweet young patient, Kerry, who was taking a long time to die.

I was pretty certain the slouch in Yvonne's shoulders were the result of emotional exhaustion. Compassion fatigue. It certainly met the criteria, yet the subtext to that description was tied to her suffering. With Kerry, more than with other patients or with all of our patients combined, the stress came from the sheer unfairness of the situation. How much suffering did one person have to endure?

“How are you doing?” I asked.

Yvonne looked up from the computer, and I nodded toward Kerry's door. In the instant she registered that my question was about how she was handling a difficult situation tears pooled in her eyes.

CASE

Kerry's care was hard on everyone involved, but perhaps hardest on the bedside nurses. One of her other nurses explained by saying, “the hardest part is not being able to connect with her.”

Collectively the nurses on the unit decided to rotate their patient assignments. Too many days in a row was emotionally taxing. Yet needing to rotate carried its own burden and the nurses questioned their actions: Were we bad nurses if we requested a break? Did we need to hide our sadness from our co-workers? How can we decide to alternate assignments when Kerry had no choices in her care or her disease progression?